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Pediatric > Pediatrics 1 > Flashcards

Pediatrics 1 Flashcards

1
Q

muscle recession vs resection

A

recession: weakens muscle resection: strengthens, tightens muscle

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2
Q

Three axes of Fick

A

Movement of the globe takes place around the axes, termed x, y, z - axes, which pass through the center of rotation of the globe. X axis: movement occurs in the vertical direction along this axisy axis: torsional movements occur along this axisz axis: horizontal movements occur along this axis (abduction, adduction)

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3
Q

Listing’s Plane

A

a plane passing through the head and the center of rotation of the eyes, that is perpendicular to the line of sight when the eyes are in the primary position. The X axis and Z axis of Fick make up this plane.

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4
Q

Arc of contact

A

The point of physiologic/effective contact of the extraocular muscles at their insertion to the globe. The length of muscle that is actually in contact with the globe constitutes the arc of contact

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5
Q

What are the primary secondary and tertiary actions of the ocular muscles in primary position?

A
  • MR: adduction * LR: abduction * SR: elevation, intorsion, adduction. * IR: depression, extorsion, adduction. * SO: intorsion, depression, abduction. * IO: extorsion, elevation, abduction. Vertical muscles adduct, oblique muscles abductsuperior muscles intort, inferior muscles extort
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6
Q

What does Field of action mean in regards to EOM’s?

A

One of two things: 1. The position of the eye if a EOM were the only muscle to contract or2.The gaze position in which the extra ocular muscle has maximal effect

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7
Q

What is the angle between the visual axis and the plane of the vertical muscles? the oblique muscles?

A

23 degrees51 degrees

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8
Q

What is the term for the nasal rotation of the superior corneal meridian? how about temporal rotation?

A

incyclotorsionexcyclotorsion

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9
Q

Sherrington’s Law

A

Increased innervation to an agonist muscle is accompanied by a corresponding decrease in innervation to the antagonist muscle

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10
Q

Hering’s Law

A

NAME?

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11
Q

Yoke muscles

A

Primary muscles that perform a given version. Each muscle has a yoke muscle in the opposite eye.Ex: Right gaze–right LR + Left MREx: Up and right–Right SR + Left IO

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12
Q

PRIMARY DEVIATION VS SECONDARY DEVIATION

A

PRIMARY = THE DEVIATION OF THE PARETIC EYE WHEN THE NORMAL EYE IS FIXATINGSECONDAY = DEVIATION OF THE NORMAL EYE WHEN THE PARETIC EYE IS FIXATING

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13
Q

Tonic Convergence

A

Anatomic axis such that tonic convergence required to keep eyes ortho, otherwise an exotropia would exist. affected by sleep, alcohol, drowsiness, and anesthetic agents

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14
Q

Proximal Convergence

A

Convergence which arises due to awareness of nearness of a target (e.g. when looking through a microscope)

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15
Q

Fusional convergence

A

A movement to converge and position the eyes so that similar retinal images project on corresponding retinal images.

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16
Q

How fast are saccadic eye movements? smooth pursuit?

A

400-500 degrees/sec30-60 degrees/sec

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17
Q

Vieth-muller circle

A

same as the theoretical horopter which is a circle of corresponding retinal points when the eyes are fixated at a certain point

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18
Q

empirical horopter

A

one found experimentally, from finding corresponding retinal points, deviates from theoretical horopter in that it is larger

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19
Q

Panum’s Area

A

Imaginary 3D region in front and behind horopter where points are fused perceptuallyOutside of Panum’s area diplopia is experienced

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20
Q

What contributes to depth perception?

A

Steropsis and monocular clues. Beyond 20ft monocular clues are the sole means of depth perception

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21
Q

Striate Cortex

A
  • AKA Primary visual cortex, VI, Area 17
22
Q

Magnocellular system

A

originates with the parasol retinal ganglion cells that have large somas, dendritic fields, and axons. Rare in the fovea and increase in the near periphery. Terminate at the magnocellular cells of the LGB. Sensitive for detecting stimuli but not stationary objects. 10% of retinal input from these cells.

23
Q

Parvocellular system

A

Originates in midget retinal ganglion cells which have small somas and dendritic fields. High in density at the fovea and decrease peripherally. Synapse with parvocellular cells of the LGB. Responsible for high resolution and color contrast. 80% of retinal input

24
Q

Koniocellular system

A

Originates at bistratified retinal ganglion cells. Have large dendritic fields and synapse at Kioniocellular LGB cells. Not much known about but involved in color vision, particular blue.

25
Q

ocular dominance columns

A

NAME?

26
Q

non-alternating versus alternating suppresion

A

Non-alternating: non-dominant eye always suppressedAlternating: alternates from eye to eye

27
Q

Facultative versus obligatory suppression

A

facultative: only when the eye is in the deviated stateobligatory: always, even when not in the deviated state

28
Q

What is NRC, normal retinal correspondence?

A

The images of each eye form on similar (corresponding) parts of the retinas of each eye, e.g., the foveas. This results in binocular vision and stereopsis.

29
Q

Anomolous retinal correspondence

A

a condition wherein the fovea of the fixating eye has acquired an anomolous common visual direction with a peripheral retinal element in the deviated eyeARC is an adaptation that restores some sense of binocular cooperation

30
Q

paradoxical diplopia

A

when ARC persistst post-operatively despite alignment of eyes. Usually last only a few days to weeks

31
Q

homonymous diplopia

A

A form of double vision in which the false image is on the same side as the affected eye aka, uncrossed diplopia

32
Q

heteronymous diplopia

A

A form of double vision in which the false image is on the same side as the healthy eye. Also called crossed diplopia .

33
Q

meridional amblyopia

A

a form of amblyopia in which there is a permanent, uncorrectable reduced acuity for the contours of a specific orientation

34
Q

What is the most common type of deviation?

A

esodeviation, accounting for 50% of pediatric deviations

35
Q

Infantile (congenital) esotropia

A
  • 6 months or earlier * Large angle deviation (>30pd comitant)OEAd + DVD/DHD > 50% of kids over 1-2yrsPersistant smooth pursuit asymmetry throughout life* Amblyopia in 30% * Normal Refractive error for age (usually) * + FH often * Occurs in 30% of children with neuro/devel disease (e.g. cerebral palsy, hydrocephalus) * Treat amblyopia (patching/atropine) and ametropia (if present) before surgery * Early surgery important
36
Q

Accommodative esotropia

A

Convergent acquired deviation associated with activation of the accomodative reflex * Onset mean 2.5 yrs * intermittent progressing to constant * + FH * often associated w/ amblyopia * diplopia often occurs but disappears b/c of suppresion

37
Q

What are the different categories of accomodative esotropia?

A
  1. refractive accomodative esotropia (normal AC/A)2. Non-refractive (high AC/A)3. Partially accomodative
38
Q

refractive accomodative esotropia

A

Hyperopes (mean of +4) Treat w/ correction although strabismus still remains when correction no worn

39
Q

Tenacioius proximal fusion

A

A proximal vergence aftereffect that occurs in some patients with intermittant exotropia-Deviation typically greater at distance than near but after occlusion the near deviation increases

40
Q

What are the 4 types of intermittant exotropia?

A
  1. Pseudo divergence excess exotropia–have large deviations at distance plus at near which becomes minimal after using monocular occlusion or 3+ lenses2. Basic–X(T) equal at distance and at near3. Divergence excess–X(T) greater at distance4. Convergence insufficiency–X(T) greater at near
41
Q

Consecutive Esotropia comes from

A

esotropia after surgery for priorexotropia.

42
Q

infantile exotropia

A

much more rare than infantile esotropia and associated more often with neurologic/developmental conditions

43
Q

What is Sensory Exotropia? What are the causes?

A
  • A constant unilateral XT due to a decrease or loss of visual function in 1 eye. * Causes: congential/traumatic cataract, corneal scar, optic atrophy, macular disease, ptosis, uncorrected anisometropia
44
Q

Consecutive exotropia

A

Exotropia following esotropia corrective surgery

45
Q

Dissociated horizontal deviation

A

Movement of one eye horizontally while the fellow eye is fixating

46
Q

Dissociated vertical deviation

A

Upward movement of eye when fellow eye is fixating on an object. Can be present in both eyes

47
Q

A pattern deviation

A

Horizontal deviation that is more pronounced in down gaze than in up gaze

48
Q

V pattern deviation

A

horizontal deviation that is more pronounced in up gaze than in down gazeClinically significant when at least 15 prism diopter difference

49
Q

What is the difference between primary and secondary inferior oblique overaction?

A

Primary is when there is no associated superior oblique muscle paralysis.Secondary is associated with SO paralysis

50
Q

What is the average corneal length of a newborn?

A

9.5-10.5It reaches the average corneal length of an adult by 1 year of age

Pediatric (4 decks)

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